Exception to sick leave rules improves work prospects
Individuals on long-term sick leave have better prospects of returning to their regular job with the same number of working hours if their capacity to work is assessed using the new exception that was introduced in 2021. However, the Swedish Social Insurance Agency uses the exception unnecessarily often, according to the audit of Swedish National Audit Office (“the Swedish NAO”).
In order to enable more individuals on long-term sick leave to return to their regular jobs, the sick leave rules were changed in 2021. The requirements were then lowered for using the exception, meaning that a person’s work capacity is assessed in relation to their regular job rather than in relation to the labour market at large, after 180 days of sick leave.
The audit of the Swedish NAO shows that the change has partly had the desired effect, since individuals granted the exception have greater prospects of returning to their regular jobs with the same number of working hours as before they were signed off sick, within a year of their sick leave period commencing.
On the other hand, fewer than half of those granted the exception return to their regular job and with the same number of working hours as before they went on sick leave. This indicates that an improvement is needed in the precision of the Swedish Social Insurance Agency’s assessments.
Following the rule change, use of exceptions has also increased from 10 per cent to over 60 per cent in the 180-day assessment. It is considered that the increase is partly due to how the provision for the exception is designed, and to the fact that the Swedish Social Insurance Agency’s guidelines are not sufficiently clear.
“The exception has become the main rule, which was not the intention. The Swedish Social Insurance Agency should provide its administrators with better tools to enable applying the exception where it best enables people to return to their regular jobs,” says Auditor General Helena Lindberg.
The audit also shows that the Swedish Social Insurance Agency is falling short in its coordination remit. In only half of examined cases, the agency has been in contact with employers, and the plan for returning to work that employers are to draw up is also rarely cited as grounds for decisions.
“In order for insured individuals to have real possibilities of returning to their own jobs, the Swedish Social Insurance Agency should bring up any rehabilitation needs at an early stage. In this respect, the agency needs to improve its governance,” comments Nina Granqvist, project leader of the audit.
Recommendations
It is recommended that the Government review the design of Chapter 27, section 48 of the Social Insurance Code concerning overriding reasons, with a view to improving uniformity and precision in application.
It is recommended that the Swedish Social Insurance Agency
- develop decision support with the aim of empowering administrators in their role as civil servants in terms of requirements for equal treatment in assessing entitlement to sickness benefit.
- ensure that follow-up and evaluation are used to enhance quality in case processing.
- to a greater extent, make contact with employers regarding information on plans for returning to work in cases where overriding reasons are applied.
New sickness insurance rules
When sick leave starts, capacity to work is assessed in relation to the insured individual’s regular job. After 90 days, it shall also be considered whether the person can perform other work at the employer. After 180 days, the Swedish Social Insurance Agency shall assess work capacity in relation to commonly performed work in the entire labour market.
However, there are exceptions whereby the assessment can be deferred for six months – to 365 days – if it presents an opportunity for the person to return to their regular job. Before March 2021, “special reasons” were required for deferring the assessment, but today “overriding reasons” suffice. The purpose of the rule change was to give insured individuals better prospects of returning to their regular jobs.
Press contact: Olle Castelius, phone: +46 8-5171 40 04.
Presskontakt: Olle Castelius , telefon: 08-5171 42 06.
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